School of Nursing, Columbia University, New York, New York, USA.
Sinclair School of Nursing, University of Missouri, Columbia, Missouri, USA.
J Am Med Inform Assoc. 2021 Feb 15;28(2):342-348. doi: 10.1093/jamia/ocaa253.
This research brief contains results from a national survey about telehealth use reported in a random sample of U.S. nursing homes.
The sample includes nursing homes (N = 664) that completed surveys about information technology maturity, including telehealth use, beginning January 1, 2019, and ending August 4, 2020. A pre/post design was employed to examine differences in nursing home telehealth use for nursing homes completing surveys prior to and after telehealth expansion, on March 6, 2020. We calculated a cumulative telehealth score using survey data from 6 questions about extent of nursing home telehealth use (score range 0-42). We calculated proportions of nursing homes using telehealth and used logistic regression to look for differences in nursing homes based on organizational characteristics and odds ratios.
Significant relationships were found between nursing home characteristics and telehealth use, and specifically, larger metropolitan homes reported greater telehealth use. Ownership had little effect on telehealth use. Nursing homes postexpansion used telehealth applications for resident evaluation 11.24 times more (P < .01) than did nursing homes pre-expansion.
Administrators completing our survey reported a wide range of telehealth use, including approximately 16% having no telehealth use and 5% having the maximum amount of telehealth use. Mean telehealth use scores reported by the majority of these nursing homes is on the lower end of the range.
One solution for the current pandemic is to encourage the proliferation of telehealth with continued relaxed regulations, which can reduce isolation and preserve limited resources (eg, personal protective equipment) while maintaining proper distancing parameters.
本研究简报包含了一项针对美国养老院随机样本进行的关于远程医疗使用情况的全国性调查的结果。
该样本包括养老院(N=664),它们在 2019 年 1 月 1 日至 2020 年 8 月 4 日期间完成了关于信息技术成熟度的调查,包括远程医疗使用情况。采用预-后设计,在 2020 年 3 月 6 日远程医疗扩展后,比较了在调查前和调查后完成调查的养老院的远程医疗使用情况的差异。我们使用来自 6 个关于养老院远程医疗使用程度的问题的调查数据计算了一个累积远程医疗评分(评分范围 0-42)。我们计算了使用远程医疗的养老院的比例,并使用逻辑回归根据组织特征和优势比来寻找养老院之间的差异。
养老院的特征与远程医疗的使用之间存在显著关系,特别是大都市的养老院报告了更高的远程医疗使用。所有权对远程医疗的使用影响不大。扩张后,养老院对居民进行评估的远程医疗应用使用频率是扩张前的 11.24 倍(P<.01)。
完成我们调查的管理人员报告了广泛的远程医疗使用情况,包括约 16%的养老院没有远程医疗使用,5%的养老院使用了最大量的远程医疗。这些养老院中大多数报告的远程医疗使用平均得分处于较低水平。
当前大流行的一个解决方案是通过继续放宽监管来鼓励远程医疗的普及,这可以减少隔离,保护有限的资源(如个人防护设备),同时保持适当的距离参数。